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Results
In line with the PICOT question, the incidence rates of facility-acquired PUs before and after implementing the evidence-based intervention were computed and compared to establish whether the incidence rate improved after the eight weeks. The evidence-based practice project involved residents admitted to long-term care and nursing facility. The 320-bed facility ranked average in short- and long-term care provision. In 2019, it recorded 13.9% cases of high risk-patients developing PUs during their stay compared to the 8.4% average reported in New York and the national average of 7.3%. Accordingly, it was hypothesized that adopting the AHRQ Preventing Pressure Ulcers in Hospitals Toolkit would lower the incidence of PUs within the facility.
Participants in this evidence-based project were adult residents, with 50% of them being female. The rationale behind having an equal number of males and females in the sample was to minimize gender-related confounding factors. By minimizing the confounding variables, which are either correlated to the independent variable or causally related to the dependent variable, the differences in outcomes between the pre- and post-implementation scores could be attributed to the intervention implemented.
The incidence rate was computed by dividing the number of residents developing a PU by the number of sample residents and represented as a percentage. Accordingly, the pre-implementation incidence rate was computed by calculating the percentage of residents who developed PUs within the sample of 50 patients at the start of the project. Likewise, the post-implementation incidence rate was calculated by computing the percentage of residents who developed PUs in the sample after completing the project. Table 3 below summarizes the pre- and post-implementation .
Table 3
Pre-Implementation and Post-Implementation PU Incidence Rates
Total sample Residents with PUs Incidence Rate
Pre-Implementation 50 7
14%
Post-Implementation 50 3 6%
Based on the results in Table 3, the PU incidence rate was 14% before implementing theAHRQ Preventing Pressure Ulcers in Hospitals Toolkit , and this rate declined to 6% after the implementation of the intervention. Figure 1 illustrates the comparison of pre- and post-implementation PU incidence rates.
Figure 1
Pre- and Post-Implementation PU Incidence Rates
The decline in the incidence of PUs is significant when one computes the percentage change.
Overall, the results indicate that the primary outcome, improving incidence rates of PUs, was obtained.
The secondary outcome was whether the implementation of the AHRQ’s PU Prevention Pathway lowered the risk of developing PUs as measured by the Braden risk assessment scale. Table 4 below shows the pre-implementation risk levels. The pre-implementation risk levels indicate that each resident had a Braden score of 12 and below. Consequently, all the participants were at a high risk of developing PUs at the start of the project.
The post-implementation risk levels were considerably different. Table 5 below illustrates these scores.
After eight weeks, 86% of the participants demonstrated a low risk of developing PUs, while 14% had a moderate risk based on the Braden scale. Consequently, the intervention lowered the risk of developing PUs considerably. Table 6 below illustrates paired sample statistics.
Table 6 above shows the mean, sample size, standard deviation, and standard error mean for the two measurements: before and after the intervention. The pre-implementation mean was 3.0, which implies that most, if not all, residents had a high risk of developing PUs. On the contrary, the post-implementation mean was 1.14; hence the risk of contracting PUs was lower than the initial one. Table 7 below depicts the outcome of a paired sample t-test done using SPSS.